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If You Bill Medicare, You Better Read This: NSC Revalidation

Posted on in Billing/Reimbursement

By Ronda Buhrmester and Dan Fedor, VGM Reimbursement Team

The National Supplier Clearinghouse (NSC) is required to revalidate DMEPOS suppliers every three years. When it is time for a supplier to revalidate, the NSC will send a letter with steps to follow and a bill for the $560 fee.

The CMS 855S application form

One of the steps toward revalidation is to complete the CMS 855S application form. The 855S was recently revised, becoming effective Dec. 31, 2016. For additional information, click here

The updates to the form include the following in Section 3D under “Products and Services Furnished by this Supplier”:

  • Differentiated between new and used support surface by putting them into separate categories.
  • Deleted hemodialysis equipment and/or supplies because it’s solely a Part A benefit.
  • Put external infusion pumps and/or supplies and insulin infusion pumps and/or supplies into two separate product categories so the supplies are independent of the pump.
  • Replaced the category titled “Invasive Mechanical Ventilation Devices” with “Ventilators All Types - Not CPAP or RAD.”
  • “Repairs” was added to the categories for standard manual related accessories and standard power wheelchair related accessories.

Note: There is no need to complete the 855S form unless you are revalidating, adding a service, removing a service, changing locations, etc.  

Unannounced site inspection

Another step toward revalidation is an unannounced site inspection that is conducted by a contracted company. The site inspector needs to show photo identification and have a copy of the letter from the NSC. The site inspector will take pictures and has a checklist of questions based on the 30 Medicare supplier standards.

The site inspector may request any of the information below:

  • Licensure – Any federal, state and/or and local licensure required to operate your business (supplier standard 1)
  • Insurance – Certificate of general liability insurance showing NSC as the certificate holder with the NSC’s address of PO Box 100142, Columbia, SC 29202 (supplier standard 10)
  • Inventory – Credit agreements or invoices (supplier standard 4) 
  • Complaints – Complaint resolution protocol and complaint log/form (supplier standards 19 and 20) 
  • Warranty coverage notification (supplier standard 6)
  • Rent/purchase option notification (supplier standard 5) 
  • Ownership/Management – Listing of all owners/management to include names and titles (supplier standard 17) 
  • Surety bond agreement (supplier standard 26) 
  • Accreditation information (supplier standard 22) 
  • Instructions – Documentation for written instruction/information on beneficiary use/maintenance of supply (supplier standard 12) 
  • Oxygen Licensure – A supplier must obtain oxygen from a state-licensed oxygen provider. The supplier must be able to submit a copy of that provider’s state oxygen license if requested. (supplier standard 27)
  • Signage – Business sign with company name and hours of operation are required to be posted. (supplier standard 7) 
  • Accessibility to Physical Site – Physical location must meet all federal accessibility guidelines. (supplier standards 1 and 7) 

If you have any questions about this information, please contact us at the following:

Ronda Buhrmester, 888-665-6515,  ronda.buhrmester@vgm.com

Dan Fedor, 844-794-8459, dan.fedor@vgm.com

 

VGM Reimbursement Team Joins NSC Council

VGM’s Ronda Buhrmester and Dan Fedor are members of the National Supplier Clearinghouse Advisory Council (NSCAC). 

The NSCAC is an organization comprised of individuals representing their respective DME MAC Jurisdiction Advisory Committees/Councils. The NSCAC, recognized by the NSC as a liaison to the DMEPOS industry, was formed with the purpose of improving communication between the NSC and the supplier community, suggesting to the NSC targeted educational opportunities regarding supplier number obligations to DMEPOS suppliers, and creating a problem solving/communication link between the DMEPOS supplier community and the NSC.

The NSCAC meets regularly with NSC senior management. The next NSCAC meeting that Ronda and Dan will be attending is at Medtrade Spring in Las Vegas at the end of February.

NSCAC calling for questions

The NSCAC is calling for questions from the supplier community. Questions are due by Tuesday, Jan. 31. Please use the NSCAC question form to submit your questions, or email them to ronda.buhrmester@vgm.com or dan.fedor@vgm.com.

As members of VGM and/or US Rehab, you can reach out to either Ronda or Dan with questions or issues you may have regarding adding a location, closing a location, changing information, moving to a new location, or anything that is related to your supplier number.